Last week my D (16) was diagnosed with ADD (we've guessed it for quite a while, she's a spacey type) and began a trial w/ Concerta.

She started with 18 mg and reported that she felt "a bit happier" but that she was only able to focus for about 2 hours after she took it, then it seemed to wear off.

Also we discoverd that she HAS to take it by 7 am, last weekend she took it at 11 am and she was up till 3 am.

Anyway today she took 36 mg (per the pdoc) this am at 6:30 and she said by 9 am in school she was a mess, she couldn't concentrate on ANYTHING. By 3 pm when I picked her up she was talking non-stop, in a high pitched voice, and she kept clearing her throat over and over.

Fast forward a few hours later (now, 7 pm) and she is a raving demon! She has gone considerably downhill. She is angry, hostile, jittery, yelling for reasons that make no sense....you all have been there, you know what it's like.

Questions:

1) The pdoc prescribed Focalin for weekends, it has a shorter duration. But I was told by the pharmacist that Focalin is the same as Concerta (basically) and she would probably have the same side affects. Is this true? I don't want to put her through the same crap tomorrow.

2) Should she even try a 37 mg? Or does blah reaciton at 18 and terrible reaction at 36 spell it out?

3) If the Concerta (family) of drugs doesn't work, what would the next step be?

4) Is there any way to get my daughter to wind down? She says she is so wound up, like 100 cups of coffee...right now she went for a walk but it's going to be a LONG night. Can I give her a Tylenol PM or something?

It sounds like the 36 is too much for her body.

How long has she tried the 18 mg? Perhaps if you gave it a few days, you may get a clearer image of how effective it is. There are various factors that could impact the medication.

Focalin should be roughly the same as Concerta since they share the basic compound, methylphenidate.

If the 27 mg doesn't work either, you have a choice of a short acting methylphenidate (Ritalin), amphetamines (Dexedrine, Adderall, etc.) or a non-stimulant (Strattera). There are more medications out there for ADD, but are not as commonly used as the forementioned.

She might want to try the lowest dose of Dexedrine as her next option. I'm also the 'spacey type' and felt extremely calm on that medication. Of course, it's important to get the advice of your doctor before testing any new drug. :)

Focalin is in the same class of meds that Concerta is. It is twice as potent so you only need half the dosage (20mg of methylphenidate = 10mg of Focalin).

I'd say give the 18mg a few more days. If all goes well then maybe move up to the 27mg dose of Concerta. If things don't go well with Concerta you have other options such as Ritalin LA, Metadate CD, Focalin XR and Daytrana.

The other side of the fence has plenty of options too like Adderall XR, Vyvanse, Dexedrine.

By any chance is she taking any caffiene? Soda, Coffee, Energy drinks etc (maybe even chocolate?)

I know caffiene drives me nuts when I am on adderall or concerta.